Slow Down, You Move Too Fast…Or Not

A recent article on CNN.com reports on a new large study appearing in the Journal of the American Medical Association that shows a connection between slower walking speeds (or gait) and development of dementia. The research seems to show that a decrease in the speed at which older adults walk year to year may be an early indicator of cognitive decline and dementia. The study looked at the pace of walking as well as the ability of participants to answer certain cognitive/memory questions, then drew conclusions about their relationship.

Although it was a large study (17,000 subjects), more research should follow. As I read the article, I wondered about a chicken and egg question. Did walking speed decrease because of lower cognition, or did cognition somehow decrease because of slower walking? If the second is the case, then it would make sense that we should regularly monitor people to see if they are literally slowing down; if so, they should be put on a program to increase the velocity of their gait. The research does show that when both factors (slower walking and cognitive decline) are present, there is a much greater chance of dementia–as opposed to mild cognitive impairment, which is a “normal” part of the aging process.

The study seems to indicate that the connection may exist in the right hippocampus–the area of the brain associated with memory. Believe it or not, the size of the right hippocampus can actually be increased with regular aerobic exercise (the kind that elevates heart and breating rates). It is not as if we simply have to accept the fact that once we slow down we are on a slippery slope to dementia; keeping up the pace of our exercise can have a positive impact. Even stretching exercises were shown to make a difference.

More research will surely be forthcoming. This study will certainly become an important tool in assessing the risks of dementia. It also provides another reason why it is so important for older adults to remain active and engage in regular exercise. It is not just about our physical health, but about our mental well-being too!

Dementia and Physical Fitness

I recently had a discussion with a loved one about doing personal training with individuals who have irreversible medical conditions and/or cognitive decline. The focus was on whether it is ethical to accept payment to work with someone when there is little chance that the work we are doing will improve the situation.

I wrote about this tangentially in a blog post a couple of years ago in which I talked about the statement “All Lives Matter,” concluding that many people who say that really do not act in way that truly reflects it. I shared a story about an incarcerated individual with whom I have corresponded and visited for over twenty years. He is currently serving a life sentence. In 2002, he was diagnosed with a terrible cancer and called on me to counsel him on what he should do. Ultimately, he decided to undergo treatment and beat the odds by becoming cancer-free (he did the same again with a later diagnosis). One might wonder what the point is of curing one’s cancer if when it is all over s/he will still be still be incarcerated for the rest of one’s life. Is the life of an incarcerated person somehow not worth living? I learned that it is, and I have seen it played out over and over again since 2002.

In a similar vein, one could ask whether there is any point to training someone with Alzheimer’s or another end-stage disease. I addressed this in a more recent post, remembering a client who was on hospice care when I began training him. He had been athletic his whole life and his family knew that he loved to work out; in the last several months of his life, that is what we did together. Did it hold off the disease? Did it cure him? No. Did it add quality to his life on the days we were together? I would like to think so.

I do work with clients who experience cognitive decline. There are all kinds of considerations that go into carrying out this kind of training and my certifying organiation, The American Council on Exercise, has even written about it. There is research that indicates that aerobic exercise can actually help maintain (and perhaps even improve) cognitive function, but even if there was not, the quality time spent together is worth it. As with all my clients, I meet them where they are–physically, emotionally, spiritually, and mentally. I consider it a special honor to work with older adults; I believe that I make a difference in the lives of these clients (and in their families), and I know it has made a difference in mine.

What Did I Come Into this Room for…and Other Things I Worry About

PET scan of an healthy brain compared to a brain at an early stage of Alzheimer's disease.

A short, but informative and helpful, article appeared on CNN.com’s health page today that sparked my interest. Entitled, “Is My Senior Moment the Start of Dementia?,” it explores the difference between milder forms of cognitive impairment such as forgetfulness and more serious forms such as Alzheimer’s Disease. The author, Laurie Archbald-Pannone, is an associate professor of geriatric medicine at the University of Virginia.

As I have grown older, I have accepted that my memory is not what it once was. I have noticed that it seems to be much worse when I am under a lot of stress. I will make what I consider to be stupid mistakes like going to the grocery store to buy one thing and leaving with five things–none of which was the original product I intended to buy. I sometimes cannot remember a name or find the right word to express myself. I got so worried at one point (soon after my move to Cleveland and starting three jobs), that I went to a doctor and asked for a test…man, woman, person, camera, TV…I passed too!

Archbald-Pannone’s salient point is that memory loss becomes a problem when it interferes with one’s ability to do everyday activities. For instance, not remembering the name of someone you know but haven’t seen in a few years is not a problem; forgetting the name of someone you see everyday might be. Not remembering how to get to a restaurant you went to one time is probably not a problem; getting lost on the way to the dry cleaner you’ve gone to for years probably is.

The author points out that mild cognitive impairment is a natural part of aging and is usually not cause for alarm. In any case, it is always a good idea to keep one’s primary care physician apprised of any changes or concerns. Sometimes these changes are, in fact, the beginnings of something more serious.

It bears repeating (at least on my blog) that according to the the Alzheimer’s Disease Foundation’s website there are things we can do to prevent the onset of dementia. Their website lists: proper nutrition, mental activities, certain dietary supplements, and physical activity. The last one, of course, is the one that is most compelling to me. We know that cardiovascular exercise helps the heart, but when the heart is strong it helps the rest of the body. A healthy heart and vascular system is better able to circulate nutrient-rich blood to the cells. The better fed the cells, the healthier they remain. This includes brain cells. It bears repeating: physical activity becomes all the more important as we age.

To read Archbald-Pannone’s article, click here: https://www.cnn.com/2020/09/21/health/what-are-early-signs-of-dementia-wellness-partner/index.html.

And now, I’m off to the store to get some buttermilk…right?

More News on Dementia and Lifestyle

Image result for factors to prevent dementia

Well, it’s not really “news” since it is simply reconfirming what we already have seen in recent research.

There are studies recently shared at Alzheimer’s Association International Conference last week that show that there are five factors that have been shown to significantly reduce the risk of developing dementia later in life.

Both studies pointed to:

A healthy diet
At least 150 minutes a week of moderate to vigorous physical activity
Light to moderate drinking (alcohol)
No smoking
Engaging in mentally stimulating activity

Engaging in all five decreased risk of Alzheimer’s by 60% compared to those who only had one healthy behavior. Those who added only one of the habits above saw their risk lowered by 22%!

It is becoming more and more clear every day that the decisions we make about our lifestyles at every point in our lives have implications downstream. There is no point at which we are “too late” to add healthy behaviors, and when we do add them the impact is noticeable.

For the full article in http://www.cnn.com, click here: https://www.cnn.com/2019/07/14/health/dementia-risk-lifestyle-study/index.html

Judaism teaches us that we are to pursue life. This means we cannot simply wait around and see what is in store for us health-wise. We must at every moment, make healthy decisions; not only will we sense the difference now, but in the years ahead as well.

Brain Games may be just that…

CNN reported on the new global guidelines from the World Health Organization (WHO) about preventing dementia.

The guidelines reinforce what many of us in the Fitness Industry and who have an interest in brain biology already know. Many of the gimmicks that are advertised to help stave off dementia are just that–gimmicks that are not proven to really work.

For some time now, experts in brain biology have been able to cite only one factor that is known to reduce the chances of developing dementia: cardio exercise. But wait, what does the heart have to do with the brain (sounds like a country music song)? It’s actually not that complicated; the more blood that we get pumping throughout our bodies (which is what cardio exercise does), the more blood that flows to the brain; the more blood to the brain, the healthier it is!

What the WHO guidelines add is that there are now a few other factors that also can contribute to preventing dementia: “regular physical exercise, not using tobacco, drinking less alcohol, maintaining healthy blood pressure and eating a healthy diet — particularly a Mediterranean one. “

Just one more reason to head to the gym…or outside…or to that piece of cardio equipment in the basement. Not only is it good for your heart, it is good for your brain too!

Here is the article from CNN.com:
https://www.cnn.com/2019/05/14/health/who-guidelines-dementia-intl/index.html